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Individual
MS. KATHRYN ELAINE GRAVELL
Active
Individual
MS. KATHRYN ELAINE GRAVELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC,SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
08396
MD
235Z00000X
Speech-Language Pathologist
SA 9250
FL
235Z00000X
Speech-Language Pathologist
SLP-SP-LIC-4134
MT
235Z00000X
Speech-Language Pathologist
SLP005728
GA
235Z00000X
Speech-Language Pathologist
SP 0000004935
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044589267A
—
GA
01
—
08396
MD SLP LICENSE #
MD
05
—
1568536928
—
MT
05
—
892578000
—
FL
01
—
SA 9250
FL STATE SLP LICENSE #
FL
01
—
SLP-SP-LIC-4134
MT SLP LINCENSE #
MT
01
—
SLP005728
GA STATE SLP LICENSE #
GA
01
—
SP 0000004935
TN STATE SLP LICENSE #
TN
Enumeration date
11/20/2006
Last updated
07/21/2022
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